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Unlocking the Quadriceps After Knee Surgery: An Evidence-Based Approach to Treatment

Activity Details
  • Credit Amounts:
    • CME: 1.25
    • BOC: 1.00
  • Cost: $25.00
  • Release: Nov 1, 2015
  • Expires: Dec 31, 2017
  • Estimated Time to Complete:
    1 Hour(s)  15 Minutes
  • System Requirements:
  • Average User Rating:
    (2 Ratings)


Conrad M.  Gabler Conrad M. Gabler, MS, ATC
Doctoral Student
Division of Athletic Training
Department of Rehabilitation Sciences
College of Health Sciences
University of Kentucky
Lexington, KY

Carl Mattacola Carl Mattacola, PhD, ATC
Division Director, Athletic Training
Professor, Athletic Training
College of Health Sciences
University of Kentucky
Lexington, KY

Needs Statement

Restoring an athlete’s quadriceps strength after anterior cruciate ligament (ACL) reconstruction is not only critical for restoring lower extremity function, but also in prolonging long-term joint health and quality of life. However, quadriceps weakness is still present after being cleared to return to activity. Persistent quadriceps weakness that is observed after knee surgery can be explained by unresolved neural deficits at the quadriceps. Quadriceps activation deficits have been reported to be up to 25% in patients who have undergone ACL reconstruction. Furthermore, recent evidence demonstrates corticospinal alterations in patients after ACL reconstruction that further inhibits activation of the quadriceps. However, current ACL rehabilitation protocols can be improved by specifically including interventions to facilitate quadriceps activation. Therefore, ACL rehabilitation protocols that provide strategies to combat theses neural deficits are vital to restoring an athlete’s quadriceps function after surgery. The purpose of this presentation is to discuss evidence-based disinhibitory interventions and equip clinicians with the knowledge, tools, and protocols to effectively treat quadriceps activation failure.

Target Audience

This activity is designed for athletic trainers, physical therapists, sports medicine physicians, physical medicine and rehabilitation physicians, and  physician assistants. 


At the conclusion attendees will be able to:

1. Describe the consequences of quadriceps weakness after knee surgery.
    a. Recall the ramifications quadriceps weakness has on function, quality of life, and joint health
2. Discuss the neural origins of quadriceps weakness and the importance of addressing it during rehabilitation.
    a. Indicate the neural deficits that occur at the quadriceps after knee surgery
    b. Explain to their patients the importance of correcting these deficits
3. Review a variety of rehabilitation interventions that can be used to facilitate quadriceps activation.
    a. Describe the characteristics of various disinhibitory interventions
    b. Select interventions based on the recovery status of their patients
4. Recognize effective rehabilitation protocols for patients who demonstrate quadriceps dysfunction after knee surgery.
    a. Describe how to design a rehabilitation protocol from the presented material
    b. Review how to implement a rehabilitation protocol from the presented material


This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Kentucky College of Medicine, and UK College of Health Science. The University of Kentucky College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The University of Kentucky College of Medicine designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The University of Kentucky College of Medicine presents this activity for educational purposes only. Participants are expected to utilize their own expertise and judgment while engaged in the practice of medicine. The content of the presentations is provided solely by presenters who have been selected for presentations because of recognized expertise in their field.

ACGME Competencies

  • Patient care
  • Medical knowledge
  • Practice-based learning and improvement

NATABOC The University of Kentucky is recognized by the Board of Certification, Inc. to offer continuing education for Certified Athletic Trainers. This program has been approved for a maximum of 1.00 hour of EBP Category continuing education. Certified Athletic Trainers are responsible for claiming only those hours actually spent participating in the continuing education activity.

BOC Approved EBP Provider Number: P2382-2

Faculty Disclosure

No speakers or planners have any relevant financial relationships to disclose.

The material presented in this course represents information obtained from the scientific literature as well as the clinical experiences of the speakers. In some cases, the presentations might include discussion of investigational agents and/or off-label indications for various agents used in clinical practice. Speakers will inform the audience when they are discussing investigational and/or off-label uses.

Disclosure of a relationship is not intended to suggest or condone commercial bias in any presentation, but it is made to provide participants with information that might be of potential importance to their evaluation of a presentation.


This activity is jointly provided by the University of Kentucky and UK College of Health Science.

CE Content Concerns


Concerns or complaints related to ACPE or ACCME standards may be submitted in writing to the Director of UK HealthCare CECentral by fax to 859-323-2920, or by mail to 2365 Harrodsburg Road, Ste B475, Lexington, KY 40504


  • The Director or his/her designee will review, investigate, forward and/or respond to complaints and will put forth a best effort to adjudicate the issue(s), along with CECentral staff members, within two (2) weeks of receipt of the grievance or complaint.
  • If needed, concerns, complaints, or grievances will be brought before the UK HealthCare CECentral Advisory Board.
  • Issues regarding activity content also will be reviewed and addressed by the Activity Director.
  • A written decision will be issued in a timely manner by the Director of UK HealthCare CECentral or his/herdesignee.
  • Grievances will be considered when planning future activities.

Appeal Procedure

  • Persons who wish to appeal a decision should address the appeal by email, fax or in writing to the Director of UK HealthCare CECentral within two (2) weeks of receipt of the response.
  • The Director will bring the appeal to the UK HealthCare CECentral Advisory Board.
  • The results of the appeal will be sent to the participant no later than two (2) weeks following the meeting of the board.